Some veterans have to choose between medically prescribed marijuana and painkillers. / Ruben Lammerink, Getty Images/iStockphoto

by Jolie Lee, USA TODAY Network

by Jolie Lee, USA TODAY Network

Military veterans are increasingly able to turn legally to marijuana to treat pain and the symptoms of post-traumatic stress syndrome.

But disclosing their marijuana use to the Department of Veterans Affairs sometimes comes with a price.

Veterans who tell the VA about participating in a state marijuana program say they have been forced to choose between their prescription narcotic painkillers - such as Vicodin, Oxycontin and Percocet - or marijuana, said Michael Krawitz, president of Veterans for Medical Marijuana Access.

Marijuana alone "certainly is not a replacement for somebody's narcotic pain medication," Krawitz said. "Most veterans would see quite a dramatic difference."

Although VA doctors cannot recommend marijuana as medicine to their patients, the VA does not explicitly ban patients from participating in state marijuana programs.

Per VA's policy, a veteran who reports marijuana use to their doctor cannot have his or her VA benefits taken away. But patients can have their treatments "modified."

At the VA, patients who get narcotic painkillers must sign what's called an opioid pain care agreement. As part of the agreement, the patient consents to a urine, saliva or blood test to "make sure your opioids get into your body," according to a copy of the agreement provided by the VA.

These tests also ensure the patient is not abusing or overdosing on the drugs, as well as taking the right amount and not giving the pills to others, according to an e-mail from the VA.

These tests can also identify when a patient is using marijuana.

The VA declined to make someone available for an interview for this story. In e-mailed responses, VA spokeswoman Gina Jackson said decisions about marijuana and prescriptions are made on an individual basis.

Nationwide, 21 states and Washington, D.C., have legalized medical marijuana. It's unclear how many vets are using medicinal pot. The VA does not track the number of patients who have reported medical marijuana use, according to Jackson.

And whatever numbers would be reported to VA do not count the many who simply don't tell their VA doctors, Krawitz said.

Vets choose marijuana over narcotics

When given the choice between their prescription painkillers and marijuana, many vets choose marijuana, Krawitz said.

One such patient is Ryan Begin, a Marine who lives in Maine, where medical marijuana is legal.

"It was pills or pot, but I can't do both," Begin said he was told by VA.

Begin suffered an arm injury during a 2004 deployment in Iraq. When he returned home, Begin said he was given a "big bag of pills" and told to go home and feel better.

But on the pills, Begin said he was jittery, unpredictable and reactive.

"People feared me when I was on the pills," he said.

Begin said he went "cold turkey" off the pills and managed to transition to marijuana without too much trouble because he had a strong enough strain of the plant. He now grows his own marijuana plants. He also uses tinctures and edibles. He said the marijuana slows him down enough so he can think and get through the day.

Doctors' varied views on pot

The medical community's stance on medical marijuana is widely varied.

The American Medical Association does not endorse state medical marijuana programs, but also is calling on more controlled studies of marijuana. AMA has also urged the federal government to review marijuana's categorization as a Schedule 1 drug, the most dangerous and addictive type of drug, considered to have no medical use.

For Dr. Jeff Goldsmith, incoming president of the American Society of Addiction Medicine, marijuana is not a medicine because it has not been approved by the Food and Drug Administration and therefore has not met the standards of other approved drugs.

"It's just an illegal drug that people like to use," Goldsmith said.

But Dr. Dustin Sulak, whose patients include Begin and other veterans, said marijuana has been life-changing for his patients. In his opinion, marijuana is a safer option: People die from opiate overdoses, but they don't overdose from marijuana, he said.

"It's an herb," Sulak said. "It should be next to St. Johns wort and kava in the health food store."

Begin has become a champion for medical marijuana access for veterans. But he says it's tough to find vets who will speak publicly about marijuana. There's still a stigma around marijuana use.

"This is something I believe so strongly in that I know it works and I know other people can benefit from it," Begin said. "I'll do just about anything if it means people will have access to the same things I do."